Abstract

MOPE136 - Poster Exhibition

It takes [at least] two to share: utilizing a unique qualitative approach to understand the decision making processes influencing high risk injecting behaviors

M. Morris1, A. Bates2, E. Andrew1, K. Page1, J. Hahn1, L. Maher2

1University of California, San Francisco, United States, 2The Kirby Institute, University of New South Wales, Sydney, Australia

Background: Little
is known about how power dynamics influence injecting risk behaviors within
injecting partnerships/dyads. This qualitative study examines the development
of injecting routines and how decision making processes are made within a
unique sample of injecting partnerships (e.g., individuals who inject most
often with one another).Methods: In-depth
interviews (n=18) were conducted with 9 injecting partnerships in Sydney,
Australia. Content analysis was used to analyze the development of injecting
routines/rituals and identified factors influencing decisions about who to
inject with and whether to share syringes and injection equipment.Results: Injecting
partnerships had a median duration of injecting together of 8months, the
majority of partnerships (6) were also sexual, two were siblings and one was a
father-daughter dyad. The primary drug injected was heroin (66%), and (66%)
reported mainly injecting together. The majority (88%) reported recent high
risk injecting behavior with their partner.
All participants noted the importance of trust when deciding who to
inject with and a preference not to inject with people perceived as “junkies”
to minimize the risk of “catching something”. All participants identified a routine that
designated responsibility for scoring, mixing, or disposing of injecting
equipment to one partner. In dyads where one partner injected the other (n=5),
participants identified this as a strategy to control their use and a proxy for
intimacy. Factors that influenced decisions to share syringes included a belief
that the partner was uninfected and expected social reciprocity.Conclusions: This study provides insights into the decision-making
processes that influence injecting risk behaviors and explores the complex role
of power dynamics and their influence on risky injecting practices. These
findings are being applied to develop a theoretically driven measurement
scale for decision-making within injecting relationships.